MEDICARE: KATIE VALE-FREEBURG APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	APRN.CNP.0031424	OH

General Provider Information

NPI Number	:	1629773254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE VALE-FREEBURG APRN

Provider Business Mailing Address
First Line	:	2230 AUBURN AVE STE B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2975
Country	:	US
Telephone Number	:	513-381-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 AUBURN AVE STE B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2975
Country	:	US
Telephone Number	:	513-381-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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